Abstract
ObjectivesTo retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.MethodsInfertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.ResultsA total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0–21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p < 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p < 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29–35 and 36–43 was positively correlated with the number of retrieved oocytes (r = 0.356, p < 0.001; r = 0.461, p < 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p < 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350–0.940), AMH (OR = 1.430 95% CI: 1.130–1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790) were factors affecting clinical pregnancy.ConclusionWe found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.
Highlights
In recent years, the fertility problem of infertile women has become a major challenge for reproductive doctors
The results showed that age (OR = 0.574 95% CI: 0.350–0.940, p = 0.027), anti-Müllerian hormone (AMH) (OR = 1.430 95% CI: 1.130–1.820, p = 0.003) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790, p = 0.032) were independent factors influencing clinical pregnancy (Table 7)
We found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women aged 29–43 was positively correlated with AMH
Summary
The fertility problem of infertile women has become a major challenge for reproductive doctors. The key factors affecting infertile women are the decrease in the number and quality of oocytes. Studies have shown that AMH can reflect the number of antral follicles and the quality of oocytes [1, 2]. Several clinical studies have shown that patients with low AMH levels have a higher cancellation rate of oocytes retrieval cycles because of low ovarian response [6,7,8,9]. Some researchers pointed out that AMH levels are correlated with the number of oocytes retrieved, fertilization rate, number of embryos available and clinical pregnancy [10,11,12]. The relationship between AMH and the number of oocytes retrieved in infertile women at different ages is yet to be studied
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